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This column reflects the opinion of the writer. Learn about the differences between a news story and an opinion column.

Unintended consequences

As a retired family physician in the Spokane Valley, I look back to the decision by area (and national) hospitals perhaps 10 years ago dissuading family physicians and internists from admitting and following their own patients in the hospitals, and instead hiring hospitalists to manage inpatient care. This was done primarily (in my opinion) to expedite rapid discharges, since Medicare and private insurance companies had gone to DRGs (basically reimbursing a set amount for a given diagnosis).

I was concerned at the time about what would happen if there were a national epidemic — would there be enough doctors to go around? There seems to be a great concern now about whether there are enough respirators to serve severely ill COVID-19 patients, but I think that will matter little if we don’t have enough hospitalists, pulmonologists and intensivists to manage those patients. Don’t expect those of us who have been “out of the loop” of caring for severely ill hospitalized patients to suddenly come back to the rescue.

I’m not saying that those intensivists don’t give excellent care … they do; let’s just be aware of the limited numbers, especially when some of them get sick (as they will). Even the best-intended corporate decisions have unintended consequences.

Philip Monroe

Spokane Valley

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